OrganizationActive
Premier Therapeutic Experience
NPI 1639438955 · Preferred Provider Organization · Redmond, WA
Provider details
- NPI number
- 1639438955
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Brandon Stogsdill, Clinician(253) 970-0779
- License
- CO 60180142 (WA)
Specialties & taxonomies
Managed Care Organizations
Managed Care Organizations
Practice location
8105 166th Ave Ne
Suite 202
Redmond, WA 98052-3999
Phone: (253) 970-0779
Approximate (ZIP-level) locationGet directions
Mailing address
8105 166th Ave Ne
Redmond, WA 98052-3999
Registry dates
- Enumerated
- 2012-05-07
- Last updated
- 2012-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.